Value of Serum AFP for Differential Diagnosis of Digestive System Malignancies

ABSTRACT

Background: Now a days, Cancer is a major health problemworldwide. Common malignant disease of digestive systemincludes carcinoma oesophagus, carcinoma stomach,carcinoma colon, hepatocellular carcinoma, carcinoma biliarytree, and pancreatic carcinoma. In Bangladesh, there are a fewstudies to evaluate diagnostic value of serum AFP as tumourmarker for GIT malignancies.Aim of the Study To evaluate the diagnostic value(sensitivity, specificity, positive and negative predictive valuesas well as accuracy) of serum AFP in different malignancies ofdigestive system.Methods: This cross-sectional study was carried out at thedepartment of Gastroenterology of Bangabandhu Sheikh MujibMedical University, Dhaka, Bangladesh from October 2012 toJune 2014. A total of 200 patients with primary digestivesystem malignancies in the age group of 22 to 76 years wereincluded in this study. Malignancy of the included patients werehistologically proven and serum AFP level was measured byimmunoassay method. Serum AFP level >15 ng/ml wasconsidered as positive. Data was collected using questionnaireand clinical information data sheet. Sensitivity, specificity,positive and negative predictive values as well as accuracy ofserum AFP have shown.Results: Mean elevation of Serum AFP found to be muchhigher in advanced case than localized malignancy. Sensitivity,specificity, positive and negative predictive values as well asaccuracy of serum AFP for carcinoma stomach was 5%,73.75%, 4.55%, 75.64% and 60% respectively. Sensitivity,specificity, positive and negative predictive values as well asaccuracy of serum AFP for carcinoma colon was 0%, 72.15%,0%, 73.08% and 57% respectively. Sensitivity, specificity,positive and negative predictive values as well as accuracy ofserum AFP for hepatocellular carcinoma was 87.5%, 98.68%,95.45%, 96.15% and 96% respectively. Sensitivity, specificity,positive and negative predictive values as well as accuracy ofserum AFP for carcinoma Pancreas was 0%, 74.12%, 0%,80.77% and 63% respectively. Sensitivity, specificity, positiveand negative predictive values as well as accuracy of serumAFP for carcinoma gallbladder was 0%, 72.5%, 0%, 74.36%and 58% respectively.Conclusion: Serum AFP level has important role for diagnosisof hepatocellular carcinoma. But has no significant role for thecarcinoma of stomach, carcinoma colon, carcinoma pancreasand carcinoma gallbladder. This study stresses the need ofbroad-based work to detect the actual value of serum AFP fordifferential diagnosis of digestive system malignancies.